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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors present the case of an adult woman who was treated in the mental health system for many years for a syndrome of mixed anxiety and depression unresponsive to psychopharmacologic or psychotherapeutic treatment. A computed tomography scan revealed asymmetrical enlargement of the right temporal horn. This finding, as well as findings of severe difficulties in spatial relations together with mildly abnormal posturing of the left hand when walking (especially when the gait was stressed), suggested that the patient had a developmental disability of the right cerebral hemisphere. The authors conclude that because such patients might appear to have primarily psychiatric rather than neurologic problems, the diagnosis of right hemisphere dysfunction should be considered when the clinical presentation is indicative of atypical anxiety and affective disorders.
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PMID:A case of developmental right hemisphere dysfunction: implications for psychiatric diagnosis and management. 246 84

Although Apgar scores as indicators of physiologic depression in newborns appeared to have limited value in predicting developmental outcome, they remain attractive indicators of risk status because they are obtained routinely in this country. Unfortunately, most follow-up studies of the relationship between Apgar scores and outcome have been generally of short duration. Thus the long-term predictive value of Apgar scores is not completely known. In this study 111 otherwise normal full-term infants with 5 minute Apgar scores of less than 7 were enrolled prospectively in a follow-up program. Approximately 13% died (2) or had significant developmental disabilities (12) identified by 30 months of age. Sixty-seven percent of the children with these poor outcomes had a history of neonatal seizures. The remainder received an extensive developmental evaluation at age 5. The mean performance on psychoeducational tests of children without a history of neonatal seizures did not differ from that of a comparison group, whereas the mean of children who experienced neonatal seizures was significantly lower. Thus, low Apgar scores warrant developmental surveillance during the early years of life but, if unaccompanied by neonatal seizures, do not appear to predict more subtle developmental dysfunction evident at school entry age. However, seizures remain an ominous sign for significant early and late developmental sequelae.
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PMID:The value of Apgar scores in predicting developmental outcome at age five. 322 62

We contrasted a sample of children and adolescents with affective disorders and mental retardation with a comparison group on behavioral symptoms, associated diagnoses, and psychopharmacologic treatment. Fifty consecutive patients with both impaired intellectual functioning and at least one affective disorder admitted to a psychiatric inpatient unit for children and adolescents with developmental disabilities and psychiatric disorders were matched to a group of 50 inpatients without depression. Behavioral symptoms such as suicidal ideation or gestures, crying, irritability, sleep problems, agitation, mood lability, and social withdrawal/isolation occurred significantly more often in the affective group than in the comparison group. Aggression, however, was the most frequent behavior concern for both groups, whereas disruption/destruction was identified significantly more often in the comparison group. Regarding Axis I diagnoses, the comparison group was more often identified with externalizing disorders (ADHD, ODD), though there was a high rate of comorbidity in the affective disorder group. The behavioral symptoms used to diagnosis normally developing children and adolescents appear to be applied in making affective disorders diagnoses in this sample of children and adolescents with mental retardation.
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PMID:Affective disorders in hospitalized children and adolescents with mental retardation: a retrospective study. 765 3

The long-term impact of a life skills-training program for mothers of children with a variety of developmental disabilities was evaluated. The components of the program included a cognitive-behavior approach designed to reduce stress and depression, improve communication and problem-solving skills, and improve satisfaction with social support networks. Participants completed assessment measures at pretest, posttest, and at a 20- to 26-month follow-up. Mothers in the skills-training class reported lower stress at posttest, lower depression levels at 2-year follow-up, and improved coping skills at posttest and 2 years later. Single mothers in the skills-training program reported the greatest satisfaction with their relationships with professionals. Mothers of children with moderate disabilities reported greater satisfaction with intimate relationships than did mothers of children with either mild or severe disabilities.
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PMID:Two-year follow-up of skills training with mothers of children with disabilities. 768 75

The use of fluoxetine to treat chronic depression and associated self-injurious behaviour (SIB) in a woman with severe mental retardation and a man with profound mental retardation is reported. In the first case, behavioural monitoring of treatment response revealed a dramatic decrease in SIB and a normalization of the woman's sleep disturbance. In the second case, SIB and the use of mechanical restraint decreased substantially. In both cases, anecdotal reports also indicated a diminution of other depressive symptoms. These cases highlight the need to consider an affective disorder as a cause of SIB in persons with severe and profound developmental disabilities. The behaviour monitoring system proved to be a practical aid in the diagnosis of depression and evaluation of antidepressant treatment in individuals who were incapable of self-report.
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PMID:Fluoxetine treatment of depression and associated self-injury in two adults with mental retardation. 833 22

This paper investigates differences in the nature and frequency of psychiatric symptoms reported by patients with learning disability and key informants. The study involved psychiatric assessment of 100 patients with learning disabilities and key informants using the Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS-ADD), a semi-structured psychiatric interview developed specifically for people who have a learning disability. There was considerable disagreement between respondent and informant interviews: only 40.7% of cases were detected by both interviews. Respondents were more likely to report on autonomic symptoms and certain psychotic phenomena. Other anxiety and depression symptoms were more frequently reported by informants. The results indicate that it is crucial for sensitive case detection to complete both interviews where possible. If the respondent cannot be interviewed, panic disorder or phobias may be particularly difficult to detect.
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PMID:Respondent and informant accounts of psychiatric symptoms in a sample of patients with learning disability. 890 33

The present paper explores the problems associated with assessment of nutritional status in the community and reviews the literature related to this subject. The first problem is one of terminology, since a logical first step before assessment is screening, which identifies characteristics known to be associated with dietary or nutritional problems. Its purpose is to differentiate individuals who are at high nutritional risk or have poor nutritional status. There are certain factors which should alert the primary health care team to the fact that nutritional intake may be reduced and that risk of malnutrition is increased. These include disease condition, functional disabilities, inadequate or inappropriate food intake, poor dentition or difficulty swallowing, polypharmacy, alcoholism, depression, poor social circumstances or recent discharge from hospital. Patients suffering from these factors need to be identified so that screening becomes a routine part of their medical treatment. At-risk groups include the elderly, the chronically ill, those with cancer and neurological disorders, post-surgical patients and children with developmental disabilities. In the community, practice and community nurses see the majority of at-risk patients and should carry out screening. A number of screening tools have been developed for community use. Most are aimed at the elderly population, but there are others designed to assess nutritional risk in children with developmental disabilities and the general population. These are reviewed and problems of content and validity identified. Some problems associated with nutritional assessment are also reviewed.
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PMID:Problems of nutritional assessment in the community. 1034 39

We contrasted parents who had a child with a developmental disability, a serious mental health problem, and a normative comparison group with respect to parental attainment and well-being at mid-life. Data are from the Wisconsin Longitudinal Study, collected when the respondents were 18, 36, and 53 or 54, on average. Although similar at age 18, group patterns of attainment and well-being diverged thereafter. Parents of a child with a developmental disability had lower rates of employment, larger families, and lower rates of social participation but were similar to parents without a child with a disability in educational and marital status, physical health, and psychological well-being. Parents whose child had a serious mental health problem had normative patterns of educational and occupational attainment and marriage, but elevated levels of physical symptoms, depression, and alcohol symptoms at mid-life.
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PMID:Life course impacts of parenting a child with a disability. 1138 67

This study assessed the effects of social support and hardiness on the level of stress in mothers of typical children and children with developmental disabilities. One hundred and twenty mothers participated (40 mothers of children with autism, 40 mothers of children with mental retardation, and 40 mothers of typically developing children). Results indicated significant group differences in ratings of depression, anxiety, somatic complaints and burnout. Regression analyses were conducted to determine the best predictors of the dependent measures. Both hardiness and social support were predictive of successful adaptation. The relationships among hardiness, support and coping are discussed.
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PMID:Harrdiness and social support as predictors of stress in mothers of typical children, children with autism, and children with mental retardation. 1191 7

Women with Down's syndrome experience early onset of both menopause and Alzheimer's disease. This timing provides an opportunity to examine the influence of endogenous estrogen deficiency, indicated by age at menopause, on risk of Alzheimer's disease. A community-based sample of 163 postmenopausal women with Down's syndrome, 40 to 60 years of age, was ascertained through the New York State Developmental Disability service system. Information from cognitive assessments, medical record review, neurological evaluation, and caregiver interviews was used to establish ages for onset of menopause and dementia. We used survival and multivariate regression analyses to determine the relation of age at menopause to age at onset of Alzheimer's disease, adjusting for age, level of mental retardation, body mass index, and history of hypothyroidism or depression. Women with early onset of menopause (46 years or younger) had earlier onset and increased risk of Alzheimer's disease (AD) compared with women with onset of menopause after 46 years (rate ratio, 2.7; 95% confidence interval [CI], 1.2-5.9). Demented women had higher mean serum sex hormone binding globulin levels than nondemented women (86.4 vs 56.6 nmol/L, p = 0.02), but similar levels of total estradiol, suggesting that bioavailable estradiol, rather than total estradiol, is associated with dementia. Our findings support the hypothesis that reductions in estrogens after menopause contribute to the cascade of pathological processes leading to AD.
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PMID:Onset of dementia is associated with age at menopause in women with Down's syndrome. 1452 Jun 53


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